1.Latent class analysis and influencing factor study of work-related musculoskeletal disorders among operating room nurses in tertiary hospitals
Xiaogui TANG ; Li LI ; Yue ZHAO ; Ningning HU ; Feng FU ; Boya LI ; Mengru YANG ; Yinglan LI
Journal of Environmental and Occupational Medicine 2025;42(3):293-301
Background Work-related musculoskeletal disorders (WMSDs), as one of the major occupational health issues worldwide, have shown an increasing positive rate year by year. Due to the unique demands of work, operating room nurses exhibit a higher positive rate of WMSDs compared to other occupational groups, necessitating active attention and intervention. Objective To estimate the prevalence of WMSDs among operating room nurses in tertiary hospitals, explore the characteristics and latent categories of WMSDs, and analyze the influencing factors associated with the occurrence of WMSDs. Method Using a randomized cluster sampling method, operating room nurses from nine tertiary hospitals in Urumqi were selected as study participants between December 2023 and January 2024. Data were collected through a general information questionnaire, an ergonomic questionnaire for operating room nurses, and the Chinese Musculoskeletal Disorders Questionnaire. Latent class analysis was employed to examine the patterns of WMSDs among the nurses, while chi-square test and multinomial logistic regression were utilized to analyze the influencing factors of WMSDs. Result A total of 411 valid questionnaires were collected in this survey. The positive rate of WMSDs among operating room nurses in the tertiary hospitals of Urumqi over the past year was 91.9%. The positive rates, ordered from highest to lowest by body region, were neck (79.1%), shoulders (70.3%), and lower back (68.1%). The operating room nurses were categorized into three distinct groups by latent class analysis: multi-site pain group, neck-shoulder-back pain group, and neck and lower back pain group. The results of the multinomial logistic regression models revealed that gender, job strain level, ergonomic load level in the operating room, and exposure to cold or drafty working conditions or not were significant influencing factors for reporting WMSDs among operating room nurses. Specifically, having less than 5 years of work experience, low ergonomic load level, low job strain, and moderate job strain were identified as protective factors against WMSDs. Conversely, exposure to cold or drafty working environments and being female were identified as risk factors for WMSDs. The logistic regression models also indicated that compared to the neck-lower back pain group, the neck-shoulder-back pain group had a higher probability of reporting low job strain (OR=0.168, 95%CI: 0.029, 0.968) and being female (OR=4.847, 95%CI: 2.506, 9.378). In contrast, when comparing to the neck-lower back pain group, the multi-site pain group had a higher probability of reporting, low-level ergonomic workload (OR=0.079, 95%CI: 0.015, 0.412), low job strain (OR=0.019, 95%CI: 0.002, 0.145), moderate job strain (OR=0.080, 95%CI: 0.016, 0.401), high job strain (OR=0.132, 95%CI: 0.027, 0.647), less than 5 years of work experience (OR=0.173, 95%CI: 0.044, 0.683), being female (OR=2.424, 95%CI: 1.130, 5.200), and exposure to cold or drafty working environments (OR=3.277, 95%CI: 1.657, 6.481). Conclusion The positive rate WMSDs among operating room nurses in tertiary hospitals is notably high in Urumqi, with distinct co-occurrence characteristics observed within the population. To mitigate the risk of WMSDs, it is essential to implement targeted health education and prevention training programs tailored to different patterns of WMSDs. Additionally, improving working conditions, optimizing human resource allocation , and other proactive measures should be undertaken. These efforts will effectively reduce the incidence of WMSDs among operating room nurses and safeguard their occupational health.
2.Mechanism of Shengmaisan Regulating Cardiac Remodeling of Arrhythmias with Deficiency of Qi and Yin
Jingheng WEI ; Xiaolu SHI ; Wei YANG ; Cong HUANG ; Mengru SHI ; Runhao MA ; Mingjie SUN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(4):248-259
Arrhythmia is an important disease among cardiovascular diseases. Malignant arrhythmias often occur clinically and are induced by abnormal ion channels, electrical activity disorders, myocardial fibrosis, inflammation, dysfunctional mitochondrial biogenesis, mitochondrial calcium overload, out-of-balance energy metabolism, oxidative stress, sympathetic hyperactivity, and other pathological cardiac remodeling, and they are the main causes of sudden cardiac death. In traditional Chinese medicine, arrhythmias are considered to be palpitations, which are commonly caused by deficiency of Qi and Yin. It is often manifested as a deficiency of the spleen and stomach, resulting in malfunction of the Qi mechanism, followed by a particularly severe decline in cardiac function. Shengmaisan is a representative formula for nourishing Qi and Yin, consisting of Ginseng Radix et Rhizoma, Ophiopogonis Radix, and Schisandrae Chinensis Fructus. In recent years, clinical studies have shown that Shengmaisan and its additions and subtractions are commonly used in the treatment of arrhythmias. In this article, the mechanisms of the active ingredients of Shengmaisan in the electrophysiology, biochemistry, structure, autonomic nervous system, and subcellular fraction of the heart are reviewed, and the multi-target, multi-system, and integrality of Shengmaisan in the treatment of arrhythmias of Qi and Yin deficiency are described. In addition, energy metabolism disorder is tightly juxtaposed with Qi and Yin deficiency syndrome. Mitochondria, as the center of myocardial energy metabolism, play a paramount role in cardiac remodeling, indicating that Shengmaisan will be a salient part of future research to ameliorate cardiac pathologic remodeling through energy metabolism of mitochondria, so as to provide a theoretical basis for the clinical treatment of these arrhythmias.
3.Occupational stress, anxiety, and depression among grassroots disease control and prevention staff in Hebei Province: A qualitative comparative analysis based on fuzzy sets
Mengru YANG ; Jianguo LI ; Junqin ZHAO ; Lixin YANG ; Qiuying DONG ; Chunxiang ZHAO
Journal of Environmental and Occupational Medicine 2023;40(6):681-687
Background Grassroots center for disease control and prevention (CDC) staff undertake intensive work of disease prevention and control, and may be susceptible to occupational stress, anxiety, depression, and other health problems. Objective To understand the current situation of occupational stress, anxiety, and depression among grassroots CDC staff, and to identify potential risk factor configurations for occupational stress, anxiety, and depression using fuzzy set qualitative comparative analysis (fsQCA), so as to provide a basis for effective intervention. Methods The staff working in county/district-level CDCs in Hebei Province were the target population of the current study. Stratified random cluster sampling method was used to select 1860 staff members of the target population. A questionnaire of general situation, Job Content Scale, 7-item Generalized Anxiety Disorder Scale, and Patient Health Questionnaire-9 were used. Risk factor configurations associated with health outcomes of interest were identified by fsQCA3.0 software. Results The positive rates of occupational stress, anxiety, and depression were 42.69%, 44.25%, and 47.96%, respectively. Marital status was a necessary condition for occupational stress, anxiety, and depression in the grassroots CDC staff (the necessity values were 0.911, 0.939, and 0.933, respectively). There were two types of risk factor configurations for occupational stress: "self-improvement" and "disease burden"; the risk factor configurations for anxiety were "disease burden" and "economic-disease burden"; while the risk factor configurations for depression were "disease burden", "economic-disease burden", and "self-improvement". The overall consistency scores of occupational stress, anxiety, and depression were 0.941, 0.820, and 0.774, respectively. Regarding outstanding components, "self-improvement" included pressure of job requirements and promotion, "disease burden" included impact of chronic illness on psychological state, and "economic-disease burden" included not only impact of chronic illness but also financial support for CDC staff. Conclusion All positive rates of occupational stress, anxiety, and depression are high among grassroots CDC staff in Hebei Province. Occupational stress, anxiety, and depression of grassroots CDC staff are the results of multiple influencing factors, so targeted intervention measures should be formulated.
4.Spatiotemporal Dynamics of the Molecular Expression Pattern and Intercellular Interactions in the Glial Scar Response to Spinal Cord Injury.
Leilei GONG ; Yun GU ; Xiaoxiao HAN ; Chengcheng LUAN ; Chang LIU ; Xinghui WANG ; Yufeng SUN ; Mengru ZHENG ; Mengya FANG ; Shuhai YANG ; Lai XU ; Hualin SUN ; Bin YU ; Xiaosong GU ; Songlin ZHOU
Neuroscience Bulletin 2023;39(2):213-244
Nerve regeneration in adult mammalian spinal cord is poor because of the lack of intrinsic regeneration of neurons and extrinsic factors - the glial scar is triggered by injury and inhibits or promotes regeneration. Recent technological advances in spatial transcriptomics (ST) provide a unique opportunity to decipher most genes systematically throughout scar formation, which remains poorly understood. Here, we first constructed the tissue-wide gene expression patterns of mouse spinal cords over the course of scar formation using ST after spinal cord injury from 32 samples. Locally, we profiled gene expression gradients from the leading edge to the core of the scar areas to further understand the scar microenvironment, such as neurotransmitter disorders, activation of the pro-inflammatory response, neurotoxic saturated lipids, angiogenesis, obstructed axon extension, and extracellular structure re-organization. In addition, we described 21 cell transcriptional states during scar formation and delineated the origins, functional diversity, and possible trajectories of subpopulations of fibroblasts, glia, and immune cells. Specifically, we found some regulators in special cell types, such as Thbs1 and Col1a2 in macrophages, CD36 and Postn in fibroblasts, Plxnb2 and Nxpe3 in microglia, Clu in astrocytes, and CD74 in oligodendrocytes. Furthermore, salvianolic acid B, a blood-brain barrier permeation and CD36 inhibitor, was administered after surgery and found to remedy fibrosis. Subsequently, we described the extent of the scar boundary and profiled the bidirectional ligand-receptor interactions at the neighboring cluster boundary, contributing to maintain scar architecture during gliosis and fibrosis, and found that GPR37L1_PSAP, and GPR37_PSAP were the most significant gene-pairs among microglia, fibroblasts, and astrocytes. Last, we quantified the fraction of scar-resident cells and proposed four possible phases of scar formation: macrophage infiltration, proliferation and differentiation of scar-resident cells, scar emergence, and scar stationary. Together, these profiles delineated the spatial heterogeneity of the scar, confirmed the previous concepts about scar architecture, provided some new clues for scar formation, and served as a valuable resource for the treatment of central nervous system injury.
Mice
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Animals
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Gliosis/pathology*
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Cicatrix/pathology*
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Spinal Cord Injuries
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Astrocytes/metabolism*
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Spinal Cord/pathology*
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Fibrosis
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Mammals
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Receptors, G-Protein-Coupled
5.Development and preliminary evaluation of a fluorescence RPA assay for the rapid detection of Necator americanus
LIANG Jiarui ; XU Bin ; HU Wei ; LI Mengru ; YANG Shuo ; ZHENG Bin
China Tropical Medicine 2023;23(7):681-
Abstract: Objective To establish a rapid detection assay based on fluorescence recombinase polymerase amplification (RPA) targeting Necator americanus eggs, and to evaluate its efficacy, providing technical support for rapid detection of Necator americanus in fecal samples. Methods The fluorescence RPA primers and probe were designed based on the cox1 gene of Necator americanus and then screened the optimal combination to develop the assay. The genomic DNA of Necator americanus eggs was diluted to 7 concentration gradients including 100 pg/µL, 10 pg/µL, 1 pg/µL, 100 fg/µL, 10 fg/µL, 1 fg/µL, 0.1 fg/µL, to determine the detection limit of the assay. The specificity of the assay was demonstrated by detected genomic DNA from Schistosoma japonicum, Ascaris lumbricoides, Clonorchis sinensis and Fasciola hepatica. A total of 44 fecal samples were collected and DNA extraction was performed, and the modified Kato-Katz method, semi-nest PCR method, and fluorescent RPA method were simultaneously used for detection to evaluate the sensitivity and specificity. Results The established fluorescence RPA assay can specifically amplify a fragment of 194 bp of the Necator americanus cox1 gene within 20 min, with a detection limit of 10 fg/µL. There was no cross-reactivity with Schistosoma japonicum, Ascaris lumbricoides, Clonorchis sinensis, Fasciola hepatica after specificity validation. In 44 fecal samples, 27 positive samples were detected by the fluorescence RPA assay, and 26 positive samples were detected by both the Kato-Katz and the semi-nested PCR. The fluorescence curve of sample number 1 was slightly higher than the negative control in the later stage of the reaction, but did not show a similar trend to the positive control, and was therefore judged to be a suspected negative sample. Compared with the Kato-Katz method and the semi-nest PCR method, The sensitivity of the fluorescent RPA method were 100.00% and the specificity were 94.44%, and the consistency of the detection results was good (Kappa=0.953>0.75). Conclusions The assay based on the fluorescence RPA is an efficient, sensitive and specific technique for detecting Necator americanus and it can be applied for surveillance and early warning of hookworm infection.
6.Establishment and evaluation of a LAMP-CRISPR-based nucleic acid detection method for Schistosoma japonicum
LI Mengru ; QIN Zhiqiang ; YIN Kun ; LIANG Jiarui ; YANG Shuo ; ZHENG Bin
China Tropical Medicine 2023;23(7):686-
Abstract: Objective To establish a sensitive and specific nucleic acid detection method for Schistosoma japonicum based on loop-mediated isothermal amplification (LAMP) and clustered regularly interspaced short palindromic repeats (CRISPR) technology. Methods The LAMP primers, gRNA and ssDNA probe that target Schistosoma japonicum SjR2 genes were designed according to the principles of LAMP and CRISPR. The LAMP-CRISPR reaction system was established and optimized. The sensitivity and specificity of the method were evaluated against the ten-fold serial dilutions of plasmid containing SjR2 target sequences, as well as genomic DNA at different stages of Schistosoma japonicum and other parasites, including Fasciola hepatica, Schistosoma mansoni, Taenia saginata, Clonorchis sinensis, Ascaris lumbricoides, Necator americanus, Paragonimus westermani, and Echinococcus granulosus. Additionally, 15 schistosome-infected snail and 30 uninfected samples were tested by LAMP-CRISPR and LAMP methods, respectively, to evaluate the potential of this method for screening for infected snails. Results The developed LAMP-CRISPR method was able to specifically amplify and detect the SjR2 gene of S. japonicum. The optimal reaction temperature was 37 ℃, and the optimal reaction concentrations were both 40 nmol/L for gRNA and Cas12a protein. No cross-reaction was observed with genomic DNA from other parasites such as F. hepatica. The detection limit of the method was 10 copies/μL when testing 10-fold dilutions of recombinant plasmids as a template. Furthermore, the LAMP-CRISPR method was able to accurately detect genomic DNA from S. japonicum at various stages of development, including eggs, cercariae, schistosomula, juvenile worms, and adult worms. The results of testing 45 snail samples showed no significant difference between the LAMP-CRISPR and LAMP methods for detecting infected snails (χ2=0.05, P>0.05). The sensitivity and specificity of the LAMP-CRISPR method were 100.00% (15/15) and 96.67% (29/30), respectively, compared to the gold standard, while the sensitivity and specificity of the LAMP method were 100.00% (15/15) and 93.33% (28/30), respectively. Conclusions This established LAMP-CRISPR detection method presented good sensitivity, specificity and reliability, making it a promising tool for rapid detection and risk monitoring of S. japonicum.
7.Functional annotation map of natural compounds in traditional Chinese medicines library: TCMs with myocardial protection as a case.
Xudong XING ; Mengru SUN ; Zifan GUO ; Yongjuan ZHAO ; Yuru CAI ; Ping ZHOU ; Huiying WANG ; Wen GAO ; Ping LI ; Hua YANG
Acta Pharmaceutica Sinica B 2023;13(9):3802-3816
The chemical complexity of traditional Chinese medicines (TCMs) makes the active and functional annotation of natural compounds challenging. Herein, we developed the TCMs-Compounds Functional Annotation platform (TCMs-CFA) for large-scale predicting active compounds with potential mechanisms from TCM complex system, without isolating and activity testing every single compound one by one. The platform was established based on the integration of TCMs knowledge base, chemome profiling, and high-content imaging. It mainly included: (1) selection of herbal drugs of target based on TCMs knowledge base; (2) chemome profiling of TCMs extract library by LC‒MS; (3) cytological profiling of TCMs extract library by high-content cell-based imaging; (4) active compounds discovery by combining each mass signal and multi-parametric cell phenotypes; (5) construction of functional annotation map for predicting the potential mechanisms of lead compounds. In this stud TCMs with myocardial protection were applied as a case study, and validated for the feasibility and utility of the platform. Seven frequently used herbal drugs (Ginseng, etc.) were screened from 100,000 TCMs formulas for myocardial protection and subsequently prepared as a library of 700 extracts. By using TCMs-CFA platform, 81 lead compounds, including 10 novel bioactive ones, were quickly identified by correlating 8089 mass signals with 170,100 cytological parameters from an extract library. The TCMs-CFA platform described a new evidence-led tool for the rapid discovery process by data mining strategies, which is valuable for novel lead compounds from TCMs. All computations are done through Python and are publicly available on GitHub.
8.Modified Sanpiantang Treats Nitroglycerin-induced Migraine in Rats via p38 MAPK/iNOS Signaling Pathway
Kun WANG ; Ming MA ; Yanhua YANG ; Quanna REN ; Yuhan CHEN ; Mengru YUE ; Xu ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(22):64-70
ObjectiveTo decipher the mechanism of modified Sanpiantang in the treatment of nitroglycerin-induced migraine in rats. MethodSeventy-two Wistar rats were randomized into the control, model (nitroglycerin, 10 mg·kg-1), positive control (rizatriptan, 0.89 mg·kg-1), and high- (12.96 g·kg-1), medium- (6.48 g·kg-1), and low-dose (3.24 g·kg-1) modified Sanpiantang groups. The rat model of migraine was established by intraperitoneal injection of 10 mg·kg-1 nitroglycerin. The behavioral test was carried out to measure the mechanical pain thresholds (MPT) of the periorbital region and hindpaw after successful modeling. The serum levels of nitric oxide (NO), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and interleukin-1β (IL-1β) in rats were determined by enzyme-linked immunosorbent assay (ELISA). Immunohistochemistry (IHC) was employed to determine the expression of inducible nitric oxide synthase (iNOS) in the trigeminal nucleus caudalis (TNC). Western blot was employed to determine the protein levels of iNOS and phospho-p38 mitogen-activated protein kinase (p-p38 MAPK) in the TNC. Real-time fluorescence quantitative polymerase chain reaction(Real-time PCR) was performed to measure the mRNA levels of iNOS, p38 MAPK, and IL-1β in the TNC. ResultCompared with the control group, the model group showed decreased MPT (P<0.01), elevated serum levels of NO, TNF-α, IFN-γ, and IL-1β (P<0.01), and up-regulated expression levels of p38 MAPK, iNOS, and IL-1β in the TNC (P<0.05, P<0.01). Compared with the model group, modified Sanpiantang increased the MPT (P<0.05), and the medium-dose group showed the most significant effect (P<0.01). In addition, modified Sanpiantang down-regulated the mRNA levels of iNOS, p38 MAPK, and IL-1β and the protein levels of p-p38 MAPK and iNOS in the TNC of migraine rats (P<0.05, P<0.01) and lowered the serum levels of NO, TNF-α, IFN-γ, and IL-1β (P<0.05, P<0.01). ConclusionModified Sanpiantang may treat migraine by down-regulating the expression of pro-inflammatory factors such as NO, TNF-α, IFN-γ, and IL-1β in the p38 MAPK/iNOS signaling pathway to reduce the neurogenic inflammation.
9.Progress in research and application of risk assessment methods for imported malaria in China
Shuo YANG ; Hanyin YANG ; Shuning YAN ; Jiarui LIANG ; Mengru LI ; Bin ZHENG ; Zhigui XIA ; Shang XIA
Chinese Journal of Epidemiology 2023;44(11):1820-1824
With the gradual resumption of international travel, cross-border population movement has become frequent again, risk assessment of imported malaria has important public health significance to maintain malaria elimination status in China. Currently, risk index system construction method, risk index method, mathematical model method, and infectivity-receptivity- vulnerability method are mainly used in imported malaria risk assessment in China. This paper summarizes the common evaluation methods in the risk assessment of imported malaria research in China to provide references for the further research.
10.A multicenter study of R-ISS staging combined with frailty biomarkers to predict the prognosis and early death in newly diagnosed elderly multiple myeloma patients
Yingjie ZHANG ; Hua XUE ; Mengyao LI ; Jianmei XU ; Xinyue LIANG ; Weiling XU ; Xiaoqi QIN ; Qiang GUO ; Shanshan YU ; Peiyu YANG ; Mengru TIAN ; Tingting YUE ; Mengxue ZHANG ; Yurong YAN ; Zhongli HU ; Nan ZHANG ; Jingxuan WANG ; Fengyan JIN
Chinese Journal of Geriatrics 2023;42(10):1207-1212
Objective:To improve the prognosis stratification, especially early mortality(EM), of elderly patients with newly diagnosed multiple myeloma(NDMM).Methods:In this retrospective study, univariate and multivariate Cox regression analysis were conducted to identify the independent prognostic factors associated with overall survival(OS)and the chi-square test and multivariate Logistic analysis were used to identify the prognostic factors associated with EM in 223 elderly patients(age≥65 years)with NDMM from three centers in the country.Results:Increased NT-pro-BNP(≥300 pg/ml), ECOG-PS≥2 and stage Ⅲ R-ISS were identified as three independent adverse prognostic factors of OS.The rates of EM3, EM6, EM12 and EM24 were 12.1%, 20.1%, 32.2% and 60%, respectively.The most common cause for EM6(particularly EM3)was disease-related complications resulting from ineligibility for treatment due to poor physical performance, severe organ dysfunction or treatment discontinuation due to treatment intolerance, while the most common cause for EM12(particularly EM24)was disease progression or relapse mainly as a result of inadequate treatment.R-ISS staging failed to predict EM, while decreased eGFR, ECOG-PS≥2, and increased NT-pro-BNP were able to estimate the risk of EM, with increased NT-pro-BNP as a common independent factor for EM12( P=0.03)and EM24( P=0.015). Conclusions:R-ISS staging, which primarily reflects MM biology, cannot predict EM.However, factors such as NT-pro-BNP, eGFR and ECOG-PS associated with frailty and impairment of organ functions can be used to estimate the risk of EM, among which NT-pro-BNP may be the most important independent factor for EM.Therefore, incorporation of these frailty-related biomarkers into R-ISS staging may be able to more precisely estimate the prognosis and particularly early death of elderly patients with NDMM.

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